Some people say that there are two major drawbacks to drug use in China: one is the large amount and variety of antibacterial drugs, the world’s harm! Abuse! The second is the low dosage and single variety of narcotic painkillers, the pain of the nation! Tolerate! Reflecting the current strange phenomenon of medicine. Human civilization has entered the era of requiring hospitals to be pain-free. The hospital that ignores pain and tolerates pain is not a hospital of the 21st century. A physician who is indifferent to patients’ pain is a physician who lacks good medical ethics; a physician who cannot manage pain is an incompetent physician. The medical maxim of the 16th century: Cure is accidental, the striving for relief is realistic, and the pursuit of comfort is eternal. –from The History of Western Medicine Many cancers are difficult to cure, but cancer pain can be managed. Defeating cancer is a long-term goal, and controlling cancer pain is a realistic requirement. Analgesia is the primary, and sometimes the only effective, treatment for patients with mid- to late-stage cancer. Nearly 70% of all cancer pain can be effectively treated with some simple methods. The significance of cancer pain treatment goes far beyond pain relief itself; it can also improve patients’ quality of life, ability to work, enjoy recreation, and enable them to function normally in family and society. Drug treatment is the most basic treatment for cancer pain How can we get good treatment effect? Since each cancer pain patient has different diagnosis and condition, different response to pain and treatment as well as different personal preferences, the treatment must also be different from person to person. Formulating a reasonable individualized treatment plan for each cancer pain patient is the key to cancer pain drug treatment. And among all treatment procedures, proper assessment of pain is the key to successful treatment. Pain should be evaluated at different time periods after the start of treatment, when new pain appears, and at appropriate times after treatment is administered, and treatment plans should be adjusted in a timely manner. Determining the cause of cancer pain is important for treatment Clinicians must recognize common cancer pain syndromes due to peripheral neuropathy. Timely diagnosis and treatment of these syndromes can reduce the incidence of pain-related conditions. The importance of patient self-assessment of pain for pharmacotherapy Every clinician must remember that the subject of pain assessment is the patient’s own report. To improve the accuracy of the assessment, clinicians should teach family members to use pain assessment tools at home and should also help patients describe the content including: 1. Pain Listen carefully to the patient’s description of the pain. Simple pain intensity scores include simple descriptions, numbers, and visual analog scoring methods; 2. Location Have the patient indicate the exact location of the pain on the body or on a body graphic and where the pain radiates to. 3. pain questionnaire Can help determine location and pain severity 4. pain intensity To allow the patient to maintain the same criteria when reporting pain intensity at subsequent follow-up visits or by telephone. 5. Factors for pain exacerbation and relief Ask the patient when the pain is the worst and least severe and record it on the response form. 6. cognitive response to pain Note that appropriate pain assessment tools may be used for those patients who are cognitively impaired or who have communication difficulties related to education, language, ethnicity, or culture. 7. Goals for pain control Document the patient’s preferred pain assessment tool and goals for pain control (score on the pain scale) in the history. Grading of cancer pain during drug treatment (VRS) During the application of drug treatment for cancer pain, the grading of pain can be assessed according to the following criteria: Grade 0: no pain. Grade Ⅰ (mild pain): painful but tolerable, without or with only a small amount of temporary analgesic drugs, and able to live a normal life with undisturbed sleep. Grade II (moderate pain): pain is obviously unbearable, requiring antiemetic drugs, and sleep is disturbed. Grade III (severe pain): pain is severe and unbearable, requiring analgesic drugs, sleep is seriously disturbed, and may be accompanied by plant nerve dysfunction or passive body position. Grading of cancer pain relief Observe the changes of subjective pain sensation, facial expression and living ability of patients after medication to judge the efficacy. 1.Complete remission, completely pain-free after treatment. 2.Partial remission, pain is obviously reduced, sleep is not disturbed and can live normally. 3.Mild remission, pain is relieved, but analgesia still needs to be strengthened and sleep is still disturbed. 4.Ineffective, no reduction compared with before treatment. Strengthen monitoring during the process of medication Patients who apply analgesic drugs should be monitored and their reactions should be closely observed, so that not only the patients can get the best therapeutic effect, but also the least adverse reactions can occur. Patients should be informed truthfully about the occurrence of adverse reactions so as not to increase their mental burden. It is also important to recognize that opioids often produce tolerance, i.e., reduced sensitivity to the drug, after repeated use. Therefore, health care professionals should not conclude that the patient is “addicted” to the drug. For patients with depression, antidepressants can be added to improve the therapeutic effect of analgesic drugs. Drug therapy for cancer pain is the basis of cancer pain treatment. Drug therapy is effective, relatively low risk, inexpensive, and usually has rapid action. However, even within the same type of analgesic drug family, each drug has different analgesic effects and side effects. The simple, effective, recognized and reasonable three-step cancer pain medication regimen designed by WHO can provide effective pain relief for 70% of cancer patients, and more than 75% of advanced cancer patients can have their pain relieved. When administering medication, the following 5 requirements should be noted: oral, on time, according to the step, individual differences in medication and attention to the side effects of therapeutic drugs. There are three major categories of drugs for the treatment of cancer pain: 1) non-steroidal anti-inflammatory drugs, i.e. general analgesics; 2) opioids; 3) adjuvant analgesics, sedatives and nerve-nourishing drugs, etc.